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Your Name*
Date of Birth*
How long have you been practicing yoga?*
What Styles and No. Years of each style*
When did you receive your 200 hour yoga teacher training certificate?*
What is the name of the institution where you studied and what was the certification received?*
Have you been teaching? If so, for how long, how many cases per week and what style(s)*
On a scale of 1-10, how physically active is your lifestyle currently (10 being the most active)?*
What other forms of exercise do you do?*
How long have you been doing these other forms of exercise, and how often?*
Program of interest*
Preffered Starting Date*
Preferred accommodation*
Reason for Attending a 300HR Yoga Teacher Training Program*
Do you Intend to Teach Yoga Afterwards?*
Any Injuries Or Accidents in Last 3 years *
Do you have any history of the following?Cardiovascular disease or heart attackHeadachesFamily history of strokesHigh blood pressureSevere mental illnessAneurismPhysical illness or injuryEpilepsyRecent/current communicable diseaseDiabetesGlaucoma or retinal detachmentOsteoporosisHIV+AsthmaRecreational drug useAlcohol or drug abuseOther
Do you suffer from any psychological disorders or hormonal imbalances? *
Are you taking any prescription medications? *
Additional Questions Or Comments*